Archives of orthopaedic and trauma surgery
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We studied a rare case of old dorsal displacement fracture of the trapezoid. Favorable results were obtained with sugical reduction, despite the fracture being old.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsPrimary reconstruction of traumatic bony defects using allografts.
We retrospectively reviewed 207 patients suffering from traumatic bone defect who had been treated at our institution between 1973 and 1993. Three types of traumatic bone defects were identified: I, minor; II, major cortical; III, major articular. ⋯ Types II and III posed the greatest difficulties in management. However, massive bone allografts can be successfully used in these situations, even in the early phases of treatment, but only given specific prerequisites.
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Injection techniques and immunohistochemical methods (antibodies against laminin) were performed to uncover the vascular pattern of the human tibialis anterior tendon with regard to spontaneous rupture of this tendon. Proximally, the blood supply of the tibialis anterior tendon mainly arises from the anterior tibial artery. Distally, the tendon is supplied by branches of the medial tarsal artery. ⋯ In the anterior half of the tendon, there is an avascular zone between 45 and 67 mm in length. The location of the avascular zone correlates well with the location of the most frequent site of spontaneous rupture of the tibialis anterior tendon reported in the literature. Hypovascularity has to be considered as an etiological cofactor for spontaneous rupture of the tibialis anterior tendon.
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Arch Orthop Trauma Surg · Jan 1999
Regeneration process of mechanoreceptors in the reconstructed anterior cruciate ligament.
We performed reconstructive surgery on the anterior cruciate ligament (ACL) of the rabbit using a free bone-patellar tendon-bone (BTB) graft and evaluated nerve regeneration in the graft. The right ACL of 15 Japanese white rabbits was resected and reconstructed using a BTB graft. The BTB and ACL from the contralateral knee served as controls. ⋯ The appearance of mechanoreceptors in the graft between 2 and 4 weeks postoperatively suggests that regeneration of mechanoreceptors occurred during this time period. At 4 and 8 weeks postoperatively, there was no significant difference in the number of mechanoreceptors between the intra-articular portion of grafted tendon and the contralateral ACL. The further increase between 4 and 8 weeks to control levels suggests that this regeneration may restore mechanoreceptors in BTB grafts to normal levels.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsInsufficiency fractures, an often unrecognized diagnosis.
Diagnosis of sacral insufficiency fractures is difficult since the onset is mild, and usually discomfort is attributed to degeneration of the lumbar spine. Computed tomography and radionuclide bone scans are helpful in making the diagnosis, as regular X-ray and magnetic resonance imaging usually fail to demonstrate the fracture.